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Category Archives: Over the Counter

With the summer finally in full swing, we can expect to be spending a lot more time outside enjoying the warm weather. Many of us may not think about it, but with the combination of warmer temperatures and increased activity, our bodies are losing more water than usual. If we do not replace the fluids that are lost, we are putting ourselves at risk of dehydration. Everyone has experienced minor dehydration. The common feeling of being thirsty is the body’s way of letting us know that it is becoming dehydrated and needs the lost fluids to be replaced. This signal should not be ignored, so when you feel thirsty, it’s time to get a drink of water. The problem arises when the person does not have close access to water or if they become dehydrated very quickly from too much heat exposure or exercise. At this point the symptoms of dehydration are more serious and may include weakness, dizziness, fainting, decreased urination, or deeply yellow-coloured urine. A person with any of these symptoms may require medical attention.

Fortunately, there are some very simple steps that you can take to prevent dehydration. Always bring extra water with you – especially for outdoor events or if working outside. Wear light-coloured and loose-fitting clothing as it will keep you cooler on hot, sunny days. Try to avoid exercise and exposure during high heat index days or at least limit time spent in the heat by finding a shaded area to cool down. Limit alcohol consumption, because alcohol increases water loss leading to dehydration. Many people may reach for an alcoholic beverage when they feel thirsty, but this is not a good choice as it will not replace the fluids that your body needs and it may impair your ability to sense the warning signs of dehydration.

It is important for everyone to keep hydrated, but it is especially important to ensure that children and elderly people are getting enough fluids. It may be difficult to get children to drink lots of water throughout the day, so providing them with snacks of fruits and vegetables that have high water content will help to replace those lost fluids. Some of the most hydrating foods include cucumber, iceberg lettuce, tomatoes, watermelon, strawberries, and cantaloupe. Older people may have difficulty getting around, they may be disabled or have trouble swallowing which can increase the risk of becoming dehydrated. Ensuring that they stay hydrated is extremely important as they may not sense the warning signs or simply may not communicate it with anyone.

Warmer weather and sunny days are ideal for outdoor events and activities, but please keep in mind our tips for staying cool and hydrated this summer season!

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Very few products available in your local pharmacy can claim as many uses as Omega-3 fatty acids. Omega-3s are a type of unsaturated fat that are found in high quantities in certain fish (such as salmon, herring, sardines) as well as plant sources (such as flax).

The two most common Omega-3s found in supplements are EPA and DHA. Some supplements will have their Omega-3s derived from fish oils while others will be derived from plant sources. Be sure to choose a product that lists the amount of EPA or DHA per capsule.

There has been some concern by patients over the levels of heavy metals (such as mercury) in Omega-3 fish oils. However, heavy metals tend to accumulate in the protein of the fish rather than the fats. In addition, Health Canada tests all Omega-3 products for their heavy metal content before being made available to the public.

Here are 5 common medical conditions that Omega-3s can help treat:

1. Arthritis – Omega-3s have been shown to help decrease inflammation in the body, therefore they may help relieve some of the pain associated with both osteoarthritis and rheumatoid arthritis. Between 3 – 5 grams of EPA and DHA for 12 weeks are needed for the anti-inflammatory effects.

2. Hyperlipidemia – Omega 3-s can help lower triglyceride (fat) levels circulating in the body. High triglyceride levels contribute to the formation of fat deposits in blood vessels. This can lead to hardening of the arteries, which allows for the formation of dangerous clots which can cause a heart attack or stroke. Studies have shown that 2 – 4 grams of fish oils can lower triglycerides by 20-50%.

3. Hypertension – Omega-3s have a modest effect on reducing blood pressure and may be a viable option for patients with mild hypertension who do not wish to start a prescription medication at this time. Omega-3s reduce the production of agents that constrict blood vessels and increases production of agents that open blood vessels. For cardiac health, 1 gram of EPA plus DHA daily is recommended.

4. Depression – Studies have shown that 1 gram of EPA twice daily may yield anti-depressant and/or mood stabilizing effects. Omega-3s may be suited for the treatment of specific populations, such as pregnant or lactating women where conventional antidepressants must be used with caution.

5. Loss of Vision – Recent studies have shown the beneficial effects of omega-3s on vision, specifically decreasing risk of age related macular degeneration. Further investigations are needed to confirm the results of these studies, however many ophthalmologists are now recommending that their patients take Omega-3 supplements.

If supplements are not for you, try to replace the meat in two of your meals per week with fish. Certain populations (such as Mediterranean and Inuit) that eat high amounts of fish and little amounts of red meats have much lower rates of cardiovascular disease compared to the North American populations.

Omega-3s are not for everyone. For patients on blood thinners such as Coumadin (warfarin) or Aspirin (ASA), be sure to check with your physician or pharmacist before starting on Omega-3s as they may increase the risk of bleeding.

 

           Many patients come into the pharmacy and have questions about cholesterol and what they can do to decrease it. Whether they found out they have elevated cholesterol through routine blood work or have a family history of high cholesterol, patients are curious about natural ways of lowering their cholesterol.

            There are two types of cholesterol: a “good” cholesterol (HDL) and “bad” cholesterol (LDL). For patients with high cholesterol, the goal of therapy is to increase the amount of HDL and decrease the amount of LDL. Approximately 80% of cholesterol is made by the body and only 20% comes from the food you eat.

            Many commercials for food products such as cereals and margarines are advertising that they can help lower cholesterol. The goal of this article is to examine the evidence of the effectiveness of various natural health and food products on the market that claim to lower cholesterol.

            Products that contain soluble fibres such as psyllium (ie. Metamucil) or oat bran are known as bile acid binders. These products increase the excretion of cholesterol from the body as well as increase the breakdown of cholesterol in the body to less harmful products. Between 10 and 30 grams of psyllium fibre daily mixed with others foods has been shown to have a significant cholesterol lowering effect.

            Between 1.5 and 3 grams per day of Niacin (Vitamin B3) has been shown to lower bad cholesterol while increasing good cholesterol. In some patients, Niacin can cause skin flushing (redness of the skin) as well as itching. There are “flush-free” or “no flush” Niacin products available; however, their effectiveness has not been established.

            Plant sterols and stanols often found in margarines labeled heart healthy (such as Becel Pro-activ) have been shown to prevent some of the absorption of cholesterol from the diet and can be included as part of a healthy diet high in fruits and vegetables to lower cholesterol.

            Finally, some studies have shown that between 600 and 1200mg of garlic in three divided doses can lower the levels of cholesterol and triglycerides (fat) in the body. Unfortunately, some patients report bad breath as well as nausea and flatulence when taking this amount of garlic.

            Patients who have been prescribed a cholesterol lowering medication called a “statin” such as Crestor (rosuvastatin) or Lipitor (atorvastatin) can consider taking Coenzyme Q10. Statins inhibit the synthesis of Coenzyme Q10, which may lead to muscle weakness and impaired energy metabolism.

            If you have any questions about natural health products available to help lower your cholesterol, be sure to ask your physician or community pharmacist to see if those products are right for you.

Ringworm is a common name for fungal skin infections.  These types of infections are also referred to as tinea.  They affect approximately 10% to 20% of the population. Ringworm appears as rings or round red patches with clear centers and red, scaly borders.   Tinea can affect the scalp, nails, or skin. 

Management for superficial fungal infections involves some simple non-drug methods, and over-the-counter remedies in the form of sprays lotions and creams.  Affected individuals should try to reduce moisture in the affected area.  Loose-fitted clothing made of cotton or material that absorbs moisture should be worn.  The skin should be dried completely before covering with clothing.  If the infection involves the feet, flip flops should be worn with bare feet to prevent spread to others and reinfection.

There are also many topical antifungal agents available.  Examples include Canesten cream (clotrimazole), Nizoral shampoo (ketoconazole), and Monistat-Derm (miconazole), to name a few. Creams and solutions are useful because they can be rubbed into the area.  Solutions work in hairy areas because they are easier to apply.  Powders can serve as useful additions to creams and solutions.  They are helpful when the infection is wet or oozing, or where a drying agent is needed.  When applying the antifungal product it should be applied to the lesion as well as one to two inches around the lesion.  The antifungal should also be used for one to two weeks after lesions clear to reduce the rate of recurrence.

Patients who have diabetes, or those who are immunosuppressed may need prescription oral therapy.  It is best for your doctor to assess theses fungal infections.  Fungal infections of the nail are also resistant to over-the-counter treatment. 

There are some home remedies for treating nail fungus.  Patients have tried applying Vics VapoRub and tea tree oil.  There is not a lot of evidence to suggest the efficacy of these products for this condition, however some people may wish to try them before resorting to an oral medication.

If you think you may be affected by a fungal infection there are a number of treatment options available.  Most issues can be resolved with some persistence and the proper product.  Please speak to your pharmacist about what option is best for you.